Provider Demographics
NPI:1821284548
Name:GL HOSPITALISTS OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:GL HOSPITALISTS OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-7234
Mailing Address - Street 1:PO BOX 431100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-1100
Mailing Address - Country:US
Mailing Address - Phone:305-662-7234
Mailing Address - Fax:305-662-7236
Practice Address - Street 1:9195 SW 72ND ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3488
Practice Address - Country:US
Practice Address - Phone:305-662-7234
Practice Address - Fax:305-662-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-16
Last Update Date:2008-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91840207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AH627Medicare PIN